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Deaths prevented by low blood pressure

Thousands of deaths from coronary heart disease were prevented in the UK between 2000 - 2007 according to a mathematical analysis.

Data shown in online journal BMJ Open demonstrate that more than 20,000 deaths were prevented by falls in cholesterol levels and blood pressure.

Researches wanted to quantify the contributions made by drug treatment (primary prevention) and changes in population risk factors (blood pressure and total cholesterol) to the falling rates of coronary heart disease deaths, across different socio-economic backgrounds.

The impact of statins was greatest among the most affluent in the population, suggesting that these drugs have helped maintain health inequalities between rich and poor, say the researchers.

The analysis shows that between 2000 and 2007 deaths from coronary heart disease fell to 38,000, of which 20,400 liveswere saved as a direct result of reductions in blood pressure and total cholesterol.

The substantial fall in blood pressure accounted for well over half of the total, the calculations indicated, with around 13,000 deaths prevented or postponed.

But only a small proportion (1,800) of these were attributable to drug treatment, with the rest accounted for by changes in risk factors at the population level.

Falls in blood pressure prevented almost twice as many deaths among the population's poorest as among the richest.

Falls in total cholesterol accounted for some 7,400 deaths prevented or postponed, of which (5,300 or 14% of the total) were attributable to statins, with the remainder attributable to changes in risk factors at the population level.

The researchers were not able to account for 14% of the total fall in coronary heart disease deaths between 2000 and 2007 (17,600 lives saved). These might be attributable to other risk factors for heart disease, such as stress, they suggest.